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18-20206
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18-20206
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Last modified
3/18/2019 10:28:19 AM
Creation date
3/18/2019 10:26:37 AM
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Building Department
Company Name
NESTLE WATERS NA INC
Building Department - Doc Type
Permit
Permit #
18-20206
Building Department - Name
NESTLE WATERS NA INC
Address
4330 20TH ST
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- r <br /> 16. CERTIFICATIONS AND APPROVALS(continued) <br /> 16.4 Property or Owner Representative: <br /> I accept this system as having been installed and tested to its specifications land all NFPA standards cited herein. <br /> Signed _ r Printed name:�— �} ' ate: f <br /> Organization: � i''h�113 ev a -f,0il Q Phone:_,Y_?.e a.4uti " - <br /> yr <br /> 16.5 Authority Having Jurisdiction: = <br /> I have witnessed a satisfactory acceptance test of this system and find it to be installed and operating properly <br /> in accordance with its approved plans and specifications,with its approved sequence of operations,and with all <br /> NFPA standards cited herein. <br /> Signed:: ' 9 �•.4f? Printed name: <br /> - — -- - �' - t} <br /> (organization: Title: j_ Phone: <br /> NFPA 72, Fig. 10.18.2.1.1 (p. 12 of 12) <br /> Copyright 02009 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. <br />
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